CEI is undertaking a project with the Centre for Behavioural and Implementation Science Interventions (BISI) at the Yong Loo Lin School of Medicine (National University of Singapore) to examine the feasibility of implementing the Choosing Wisely campaign in Singapore.
Started in 2012 by the American Board of Internal Medicine Foundation, Choosing Wisely is a clinician-led international campaign initiative that seeks to reduce low-value care and overuse through advancing clinician-patient dialogue on avoiding unnecessary medical tests, treatments, and procedures. Low-value care can be defined as services that provide little or no benefit to patients, have potential to cause harm, incur unnecessary cost to patients, or waste limited healthcare resources (Institute of Medicine, 2001). The mission of Choosing Wisely is to promote conversations between clinicians and patients by helping patients choose care that is:
- Supported by evidence
- Not duplicative of other tests or procedures already received
- Free from harm
- Truly necessary
Choosing Wisely™ is active in 20 countries and it works to foster dialogue between clinicians and patients with a focus on shared decision-making, with the ultimate aim of increasing the use of appropriate services and decreasing the use of low value care. By way of illustration, research by the American Board of Internal Medicine Foundation finds that the top 12 areas in which Choosing Wisely has helped to reduce unnecessary tests and procedures include use of antibiotics in upper respiratory infections, imaging for non-specific lower back pain, and routine pap tests.
In Phase 1 of this project (2021-2022) CEI is convening an advisory panel of family medicine clinicians to determine the topic area(s) on which to focus a potential trial of Choosing Wisely. This phase will assess the feasibility and acceptability of the program in the local context, as well as examining of the potential barriers and facilitators to implementation. Phases 2 and 3 of the Choosing Wisely project will use a hybrid methodology to implement and evaluate a pilot of a specific Choosing Wisely topic with clinicians.